Overview of CPT Code 19180: Excision of Breast Lesion
CPT Code 19180 refers to the surgical excision of a breast lesion, which may include tumors or abnormal growths. This procedure is performed to remove suspicious or problematic tissue for further evaluation and treatment.
When CPT Code 19180 is Used?
This procedure is indicated in various clinical scenarios.
- Presence of a palpable breast mass that requires evaluation.
- Suspicious findings on imaging studies such as mammograms.
- Biopsy results indicating atypical or malignant cells.
- Patient history of breast cancer with new lesions.
- Lesions causing pain or discomfort.
Symptoms Indicating This Procedure
Patients may report several symptoms that lead to the need for this procedure.
- A lump or mass in the breast.
- Changes in breast shape or size.
- Nipple discharge that is bloody or clear.
- Skin changes over the breast, such as dimpling or redness.
- Pain or tenderness in the breast area.
Causes and Risk Factors
Understanding the causes and risk factors can help in prevention and early detection.
- Family history of breast cancer.
- Genetic mutations such as BRCA1 or BRCA2.
- Previous breast biopsies showing atypical cells.
- Hormonal factors, including prolonged estrogen exposure.
- Age, with increased risk as one gets older.
Diagnostic Tests Before Procedure
Several tests may be conducted to assess the need for excision.
- Mammography to identify abnormal areas.
- Ultrasound to evaluate the characteristics of the lesion.
- MRI for detailed imaging of breast tissue.
- Fine needle aspiration or core needle biopsy for histological analysis.
Procedure Description
The excision procedure involves several key steps.
- Patient is positioned comfortably and given local anesthesia.
- An incision is made over the lesion to access the tissue.
- The lesion is carefully excised along with a margin of healthy tissue.
- The incision is closed with sutures or adhesive strips.
- Specimen is sent for pathological examination.
Preparation for the Procedure
Proper preparation is essential for a successful procedure.
- Avoid blood thinners and certain medications as advised by the physician.
- Do not eat or drink for several hours before the procedure if sedation is planned.
- Arrange for transportation home post-procedure.
- Wear comfortable clothing and avoid jewelry on the day of the procedure.
Recovery and Aftercare
Post-procedure care is crucial for healing.
- Rest for the first 24 hours after the procedure.
- Keep the surgical site clean and dry.
- Follow up with the physician for suture removal if necessary.
- Take prescribed pain medications as needed.
- Monitor for signs of infection such as increased redness or discharge.
Possible Complications
While complications are rare, they can occur.
- Infection at the surgical site.
- Excessive bleeding or hematoma formation.
- Scarring or changes in breast appearance.
- Nerve damage leading to altered sensation.
- Recurrence of the lesion.
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Post-Procedure Follow-Up
Follow-up care is important for monitoring recovery.
- Schedule a follow-up appointment within 1-2 weeks post-surgery.
- Review pathology results and discuss further treatment if necessary.
- Monitor healing and address any concerns or complications.
- Regular breast examinations as recommended by the physician.
Alternative Treatments
There are non-surgical options available for some patients.
- Observation for benign lesions without symptoms.
- Medication for hormonal therapy in certain cases.
- Radiation therapy for specific types of breast lesions.
- Cryoablation for targeted destruction of abnormal tissue.
Home Care Tips
Patients can take steps to aid their recovery at home.
- Keep the surgical area clean and dry.
- Avoid strenuous activities for a few weeks.
- Wear a supportive bra to minimize discomfort.
- Stay hydrated and maintain a balanced diet.
- Report any unusual symptoms to your healthcare provider.
Patient Education & Prevention
Education is key to prevention and early detection.
- Perform regular breast self-exams to detect changes early.
- Schedule routine mammograms as recommended.
- Discuss family history and risk factors with your doctor.
- Maintain a healthy lifestyle to reduce breast cancer risk.
- Stay informed about breast health and available screenings.
Billing and Coding Information
CPT Code: 19180
Category: Surgical Procedures
Common Modifiers:
- 50 - Bilateral procedure
- RT - Right side
- LT - Left side
Average Cost and Insurance Coverage
Costs can vary based on several factors.
- Average cost ranges from $2,000 to $5,000.
- Insurance may cover the procedure if deemed medically necessary.
- Out-of-pocket costs depend on the insurance plan and deductible.
- Pre-authorization may be required by some insurance providers.
Related CPT Codes
- 19181 - Breast Biopsy, Needle, Image-Guided
- 19182 - Breast Biopsy, Stereotactic, Needle
- 19183 - Breast Biopsy, Stereotactic
- 19160 - Excision of breast lesion
References and Sources
Frequently Asked Questions (FAQs)
What is the purpose of the excision?
The excision is performed to remove and evaluate a breast lesion for potential cancer.
How long does the procedure take?
The procedure typically takes about 30 minutes to an hour.
Will I need anesthesia?
Yes, local anesthesia is usually administered to minimize discomfort.
What should I expect during recovery?
You may experience some swelling and tenderness, which should improve over time.
When will I receive my results?
Pathology results are usually available within a week after the procedure.
